Digital Commons Network^™

Role Of Dynamic Capabilities In Firms' Competitiveness And Performance In The Telecommunication Sector In The United States, John L. Kahi

Walden Dissertations and Doctoral Studies

Telecommunications firm leaders often struggle to integrate dynamic capabilities into their core business processes, thereby reducing competitiveness. The purpose of this qualitative pragmatic inquiry was to explore how dynamic capabilities influence competitiveness and performance in U.S. telecommunications firms. Grounded in the dynamic capabilities view (DCV), the study addressed the overarching research question of how dynamic capabilities influence competitiveness and performance in telecommunications firms in the United States. Data were collected through semistructured interviews with six telecom and technology-sector leaders and analyzed using iterative coding and thematic analysis software. Four themes emerged: (a) continuous environment interpretation, (b) disciplined strategic commitment, (c) …

Staff Education To Improve Culturally Responsive Mental Health Care For African Immigrants, Martha Eseh

Walden Dissertations and Doctoral Studies

Mental health disparities among African immigrant populations are often influenced by cultural stigma, limited mental health literacy, and providers’ insufficient understanding of culturally specific beliefs and help-seeking behaviors. In outpatient psychiatric settings, these gaps can negatively affect engagement, diagnosis, and treatment outcomes. The purpose of this quality improvement project was to evaluate whether a structured staff education program could improve provider knowledge of culturally responsive care for African immigrant patients. Guided by the Johns Hopkins Evidence-Based Practice model, a pretest–posttest design was implemented with 13 interprofessional staff members, including psychiatric providers, therapists, and support staff, in an outpatient mental health …

Strategies To Improve Diversity In Leadership And The Representation Of Black Women Within An Integrated Nonprofit Health Care System, Dominique Clark

Walden Dissertations and Doctoral Studies

Black women have been underrepresented in health care leadership, specifically at the senior level. The purpose of this integrative review was to identify strategies that could be implemented to increase representation for Black women in health care leadership, with emphasis on senior leadership. The review question centered on sustainable strategies and best practices that support an increased representation of Black women in health care leadership. Relational leadership theory (RLT) served as the theoretical framework, demonstrating that leadership advancement is influenced by relational networks. A comprehensive literature review identified 50 articles that were critically appraised using the John Hopskins evidence tools, …

Supporting Parents Of Young Children With Type 1 Diabetes Through Telehealth: Randomized Controlled Trial Of The Reducing Emotional Distress For Childhood Hypoglycemia In Parents Intervention., Susana R. Patton, Nicole Kahhan, Holly O'Donnell, David D. Williams, Mark Clements, Kimberly Driscoll

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Parents of young children with type 1 diabetes (T1D) are vulnerable to experiencing fear of hypoglycemia (FH), an emotional condition that includes persistent and intense worry about hypoglycemia and/or use of unhealthful behaviors to avoid hypoglycemia. Despite greater uptake of continuous glucose monitors (CGMs) and automated insulin delivery systems, FH remains prevalent and under-addressed in parents of young children. As such, we developed Reducing Emotional Distress for Childhood Hypoglycemia in Parents (REDCHiP), a video-based telehealth intervention designed to reduce FH in parents by providing T1D education and teaching parents how to apply evidence-based strategies from cognitive behavioral therapy and …

Warming Climate Amplifies Vapor Pressure Deficit Limits On Gross Primary Productivity, Shiqin Xu, Nate G. Mcdowell, Tim R. Mcvicar, Diego G. Miralles, Stephen Sitch, Pablo Sanchez-Martinez, Joshua B. Fisher, Pierre Friedlingstein, Hylke E. Beck, Matthew F. Mccabe

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Ongoing climate warming may profoundly impact terrestrial gross primary productivity (GPP), a key component of the global carbon cycle. However, uncertainty in the relative roles of atmospheric water demand (vapor pressure deficit, VPD) and root-zone soil moisture (SM) limits predictions of drought impacts on GPP. Here, we show that growing-season GPP was more strongly constrained by VPD than SM globally, based on observation-constrained model estimates, satellite retrievals and Dynamic Global Vegetation Model simulations. The importance of VPD increased with higher temperatures and more severe and prolonged droughts. This pattern reflects VPD’s critical role in regulating stomatal conductance and plant hydraulic …

Capturing Nature As An Indirect Curing Strategy Of Salutogenic Architecture, Fasya Abelleia Ivanka, Rini Suryantini, Paramita Atmodiwirjo

ARSNET

This paper explores indirect curing as a spatial strategy for designing a restorative environment within the context of salutogenic architecture. Current healthcare practices support recovery mainly through direct medicinal approaches to cure ailments, with more focus on being sterile and creating isolation. The study argues that the process of indirect curing can also be implemented through architectural interventions by focusing on the integration of nature as restorative objects and healthcare settings that can aid the recovery process. This study qualitatively explores the capturing nature as an indirect curing strategy through examining four case studies of health care spaces. Based on …

Makna ‘Indah’ Lukisan ‘Kebakaran Hutan’ Raden Saleh Sebagai Perlawanan Konsep Pemikiran ‘Mooie Indiëm', Dionisius Krisnambudi, Sri Kusumo Habsari, Eva Farhah

Paradigma: Jurnal Kajian Budaya

The concept of "beautiful Indies" (mooie Indië) is understood as a project of visual discourse transformation in the Dutch East Indies. This study highlights Raden Saleh's painting "Forest Fire", which represents a romantic manifestation while simultaneously challenging colonial narratives about nature and society in the Indies. The aim of the research is to reveal the trans-cultural visual strategies employed by Raden Saleh in constructing a counter-discourse to colonial representation. The study adopts a qualitative-interpretative approach using heuristic methods, source criticism, and montage analysis, contextualized within Pierre Bourdieu's theoretical framework. Montage analysis is applied by juxtaposing and reassembling visual, …

Global Study On Newborn Hospitalization And Parental Experiences (Hope): Rationale And Design Of A Multinational Cross-Sectional Mixed-Methods Online Survey, Hope Study Working Group, Julia Hoffmann, Ruth Kemper, Helmut Hummler, Ayse Düzenli, Luc J I Zimmermann, Silke Mader, Christina Tischer, Jos Latour

School of Nursing and Midwifery

INTRODUCTION: Newborns who are born too soon, too small or sick are a vulnerable group who require special/high-dependency/intensive care after birth. Infant and Family-Centred Developmental Care (IFCDC) is an integrated healthcare approach that prioritises and values parental/familial involvement and participation by fostering competencies in essential newborn care skills and thus parental empowerment. There is a paucity of data globally on the IFCDC practice and the challenges faced by parents/caregivers during hospitalisation and post-discharge and the potential country-specific support.

OBJECTIVE: The primary objective of the HOPE study (Global Study on Newborn HOspitalization and Parental Experiences) is to assess parents'/caregivers' experiences, needs …

Factors Affecting Purchase Intention Toward Second Hand Clothes, Soumaya Mounir Kaakour, Fouad Saad

BAU Journal - Society, Culture and Human Behavior

Although the purchase of second-hand clothing remains a debated research topic, it is widely acknowledged that second-hand clothing (SHC) benefits society by reducing the waste of natural resources and promoting sustainability, however, it is yet to be determined whether the motivation behind buying second-hand clothing is driven by concerns for self, community, and nature.

This research aimed to investigate the impact of the five following factors frugality, perceived environmental knowledge, attitude, environmental concern, and mindful consumption on the purchase intention of second-hand clothing. A quantitative approach was used, and data was gathered online using Google Forms, where 308 responses were …

Enhancing Provider Engagement Through Peer-To-Peer Coaching: The Provider Ambassador Program, Jason Vallee, Jodi Stewart, Sam Verkhovsky, Steve Del Giudice, Janet Aug, Amanda Higgins, James Perry, Alice Kennedy, Brant Oliver

Patient Experience Journal

Provider burnout and disengagement are associated with diminished patient satisfaction, reduced clinical quality, and adverse organizational outcomes. Peer-to-peer coaching has emerged as a promising, scalable intervention to support provider engagement and improve the patient care experience. This study evaluates the effectiveness of the Provider Ambassador Program, a structured peer-to-peer coaching initiative designed to improve patient satisfaction by enhancing provider communication, professional behavior, and patient engagement skills. A pre-post quasi-experimental design was used to assess changes in provider CG-CAHPS ``Provider Overall'' top-box scores following coaching. Eligible providers (n = 83) across five BLANK Health locations were identified based on top-box scores …

From Talking The Talk To Walking The Walk: Reflection On Dartmouth Health's Care Experience Week, Rosie Bartel, Corey Kimpson, Tanya Lord, Victoria Lyons, Tony Serge, Brant Oliver

Patient Experience Journal

This article explores the participation of expert members from the Beryl Institute's Global Patient and Family Advisory Board (GPFAB) during Dartmouth Health's Care Experience Week, under the theme ``From Talking the Talk to Walking the Walk.'' This week aligns with the national Patient Experience Week. The Patient Family Advisor (PFA) presenters and authors of this article have shared their lived experience locally, nationally, and internationally through conferences, webinars, podcasts, videos, blogs, white papers, journal articles, books, and in many other ways for and as PFA members of a multitude of healthcare organizations co-create change that improves outcomes for all human …

Improving Human Experience In Health Care: Leveraging ``Humanistic Learning Health Systems'' To Accelerate Change At Scale, Brant J. Oliver, Jason A. Wolf

Patient Experience Journal

Included in a special segment in this issue of the Patient Experience Journal, are a series of reports on improving HX in healthcare supported by a humanistic LHS– the Dartmouth Promise Partnership Coproduction Learning Health System in New Hampshire, USA. Promise is a strategic partnership between a medical school and a multi-center rural academic health system. It integrates translational science education and research, data informatics, and scaled and networked humanistic applied change initiatives. One of these initiatives is the Care Experience Collaborative, a multi-center improvement initiative across the health system focused on improving HX. This special segment includes five reports …

Utilization Of Visual Metaphors For Improving Health Literacy, Kadir Alp Özler, Morgan Dressel, Madeline Weiner, Robert D Lucito, Alice Fornari

Patient Experience Journal

Health education is practiced in patient encounters via verbal communication and educational pamphlets. However, these techniques are faulty and do not provide true patient comprehension of their conditions and treatments reform is necessary to prevent the mortality and hospitalization rates that are linked to poor health literacy. Visual aids and metaphors are individually known to be powerful educational tools. A student organization at Stony Brook University, Artists in Medicine, has sought to synergize these tools to create visual metaphors artwork that links everyday concepts to patient illnesses to facilitate comprehension of this information. For example, one project “Aortic Dissections” depicts …

Patient Experience (Px) In Low- And Middle-Income Countries (Lmics): A Scoping Review, Yara Abou Harb, Geoffrey A. Silvera

Patient Experience Journal

Patient Experience (PX) is a growing subject in the healthcare industry due to its association with improved clinical outcomes, patient safety, and business motives. While PX is well studied in high income countries, little is known about the state of PX in Low and Middle-income countries (LMICs). Objective: The study aims to examine literature on PX and related concepts in LMICs. Methods: This study executes a PRISMA literature review of academic databases (Ovid Medline, CINAHL, EMBASE and Google Scholar) as well as hand searching of PX related websites from 2005 to 2024. Results: 67 references met search criteria. Four themes …

Virtual Caregiving And The Evolving Role Of Carers And Patients: Virtual Hospital Interview Analysis, Kanesha Ward, Tim Jackson, Jenna Bartyn, Shannon Saad, Sue Amanatidis, Owen Hutchings, Annie Y.S. Lau

Patient Experience Journal

Virtual hospitals are transforming healthcare by enabling remote monitoring and management of patients, improving accessibility and care continuity. As part of the transformation, there are changes to the roles and responsibilities of patients and their carers as they engage in virtual hospital care. The impact on family caregiving remains underexplored. Guided by Family Systems Theory, this qualitative study investigated how family caregiving roles adapt within a virtual hospital and identified opportunities to further support families. Semi-structured interviews were conducted with patients, carers, and healthcare workers from one model of care, at a metropolitan virtual hospital in New South Wales, Australia. …

Supporting Families Of Children With Craniosynostosis: A Qualitative Exploration Of Parental Usage Of Online Forums, Elisha L. Rea, Rachel M. Roberts, Amanda J. Osborn

Patient Experience Journal

Objective: Craniosynostosis is characterised by the early fusion of cranial sutures, resulting in an abnormal head shape. This study examines the psychosocial impact of a child's craniosynostosis diagnosis on families, by analysing online forum discussions. While surgery is often needed to address appearance-related and neuropsychological concerns, parents face challenges navigating their child's diagnosis. Many seek support through online forums, yet research on their experiences remains limited. This study aims to understand parental needs and experiences by analysing forum discussions. Method: Online forums were analysed using reflexive thematic analysis. Significant features of the data were systematically coded and themes reflecting …

Validation Of A Copd Patient-Reported Experience Measure (Prem-C9) In Ontario, Canada, Elaine Zibrowski, Floriana Islami, Alyson Kellar, Christopher Licskai, Madonna Ferrone, Shannon L. Sibbald

Patient Experience Journal

Objective: Patient-reported experience measures (PREM) are important tools for evaluating healthcare quality, yet their implementation in chronic obstructive pulmonary disease (COPD) care within Canada remains limited. Our objective was to examine the construct validity of the PREM-C9 instrument in a Canadian context and explore its potential clinical applications beyond measuring patient experience. Methods: A two-phase, prospective, cross-sectional, mixed-methods study was conducted across 41 Best Care COPD sites in Ontario, Canada. In the quantitative phase, confirmatory factor analysis assessed the construct validity of the PREM-C9. In the qualitative phase, focus group interviews with COPD case managers explored implementation experiences and perceived …

A Study To Assess Prom And Prem Of Cld Patients In A Tertiary Care Hospital, Anagha Nandakumar, Rubasree M, Priya Nair, Dr. Dinesh Nair, Krishnapriya S

Patient Experience Journal

Chronic liver disease (CLD) leads to progressive liver dysfunction, significantly affecting patients quality of life (QOL). Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are critical in evaluating the health status and care experiences of CLD patients. This study aimed to assess the impact of PROMs and PREMs in CLD patients undergoing endoscopic procedures. A prospective study was conducted in the Gastroenterology and Hepatology Department over three months, involving 245 CLD patients (160 inpatients and 85 outpatients). PROMs were assessed using the Liver-specific PROM (LC PROM), which focused on daily living, symptom management, psychological well-being, and treatment effectiveness. PREMs …

Patient-Centered Care To Improve Recruitment And Retention In Clinical Trials: Insights From A Real-Time Interview-Based Satisfaction Study, Christina Zhuang, Aishwarya Prasad, Anshu Arora, Arun Arora, Jeena Vaid, Wisam Aljumaili, Arif Khan

Patient Experience Journal

Patient-centered care is increasingly recognized as essential for understanding participant expectations and generating more accurate and reliable clinical trial results. This study aimed to evaluate an interview-based feedback tool designed to provide a comprehensive assessment of patient experience at a free standing high-enrolling clinical site in the Pacific Northwest. The primary objectives were to identify strengths and weaknesses in current procedures, enhance recruitment and retention, and develop a model adaptable to other sites. A structured interview tool was independently developed based on literature supporting the integration of qualitative and quantitative feedback to capture a multidimensional view of patient experience. The …

Cartoon-Printed Uniforms: A Strategy To Ease Pediatric Hospital Anxiety, Karnellya R. Ohol, Janaki P. Shinde

Patient Experience Journal

This quasi-experimental study evaluated the effectiveness of cartoon-printed nurse uniforms in reducing anxiety among hospitalized children aged 3–12 years. Conducted at a tertiary care hospital in Maharashtra, India, the study included 100 participants (50 intervention, 50 control) who received care from nurses wearing either cartoon-printed uniforms or traditional clinical attire. Anxiety was assessed at baseline and on hospital days 2, 3, and 4 using validated age-appropriate scales: the modified Faces Anxiety Scale (ages 3–6) and the STAI-C short form (ages 7–12). Mixed-effects repeated-measures ANOVA demonstrated a significant group × time interaction (F(3,294) = 42.67, p < .001, partial η² = .304). Children cared for by nurses in cartoon uniforms showed a 48.8% reduction in anxiety compared to 14.7% in controls. Between-group effect sizes increased progressively across days (d = 0.87 to 2.13), indicating cumulative benefit rather than transient novelty. Clinically meaningful improvement (≥30% reduction) was achieved by 76% of intervention participants versus 24% of controls (NNT = 1.92). Staff acceptability was high (95%). Findings indicate that cartoon-printed uniforms are a simple, low-cost, high-impact environmental intervention that significantly enhances pediatric patient experience. Their strong clinical utility, ease of implementation, and alignment with child-centered care principles support adoption across pediatric healthcare settings.

Veteran Emergency Waiting Areas And Turned-Off Televisions: An Overlooked Variable, Randall Vanadisson

Patient Experience Journal

The significance of environmental design in emergency department (ED) waiting areas is increasingly acknowledged as a vital element affecting patient experience and stress levels, especially among veterans who may already encounter heightened psychological susceptibility. Aim: To investigate the impact of a non-operational television (TV) at a veteran's medical center emergency department waiting area on patient behavior, perceived stress, and environmental involvement. Methods: This naturalistic observation study employed non-participatory observation of 19 patients in the waiting area of a Veterans Affairs hospital. Field notes captured behavioral responses, seating patterns, and nonverbal stress cues. Observable engagement with the physical environment, …

The Patient's Lived Experience: A Phenomenological Study On Factors Influencing Tuberculosis Treatment Outcomes In Medan, Indonesia, Erida Novriani, Urip Harahap, Khairunnisa Khairunnisa, Wiryanto Wiryanto

Patient Experience Journal

This qualitative phenomenological study was conducted to analyze the factors influencing tuberculosis (TB) treatment outcomes from the patient's perspective in Medan, North Sumatra, Indonesia. The objective was to uncover the nuanced human factors shaping the patient's treatment journey, moving beyond a sole reliance on statistics and quantitative methods. The research was conducted across all 41 Primary Health Centers (PHCs) in Medan. Through a purposive sampling strategy, data was collected from 22 TB patients via in-depth interviews until data saturation was achieved. The collected data was analyzed using thematic, narrative, and phenomenological approaches to interpret the detailed lived experiences of the …

Applying A Patient Journey Mapping Approach To Understand Maternal Care Patient Journeys: A Pilot Study, Nicole Hicks, Kristin Tully, Christopher Goodier, Sreenath Chalil Madathil, Ayaba Logan, Myrtede Alfred

Patient Experience Journal

Introduction: In the United States, giving birth is the most common cause of hospitalization. Maternal care frequently represents birthing people's first experiences of prolonged interactions with the healthcare system. However, the structure of services is often fragmented and misaligned with individuals' needs, particularly for Black birthing people. Documenting birthing people's experiences during pregnancy and postpartum allows for identification of practices working well and opportunities to improve patient-centered maternal care. Methods: The mixed-methods study was conducted in the southeastern United States and used patient journey mapping(PJM) to document experiences of patients receiving maternal care at a large academic hospital …

No One-Size-Fits-All: Patient Perspectives Of Key Factors Influencing Their Inpatient Rehabilitation Experience, Mirline Milien, Megan Bewernitz, Katherine Stallings, Mary Ellen Young

Patient Experience Journal

Although patient experience in healthcare settings has historically been an ambiguous concept, it has received increasing recognition as a measure of healthcare quality. Despite this growing recognition and efforts to define patient experience, few studies have explored patient perspectives on the key factors driving this quality indicator. This study aimed to explore the core elements patients view as influencing their experiences in the inpatient rehabilitation setting. This was a single-visit, cross-sectional qualitative interview study. Thirteen patients with diverse diagnoses who received at least one week of rehabilitation services were recruited from a single inpatient rehabilitation facility. Purposive sampling was employed …

The Implementation Of Family-Centered Care And Family Satisfaction In Caring For Children With Cancer, Lenny Gannika, Mulyadi Mulyadi, Jeanette Irene Christie Manoppo

Patient Experience Journal

Background: Family-Centered Care (FCC) is an approach that involves families actively in their children's care by emphasizing respect, collaboration, and support. The goal is to increase family satisfaction with the care of children with cancer. FCC covers six subscales: general satisfaction, information, family inclusion, communication, technical skills, and emotional needs. Objective: This study aims to analyze the relationship between implementing FCC and family satisfaction when caring for children with cancer. Methods: A cross-sectional quantitative study was conducted at the Estella Children's Cancer Center in Manado, Indonesia, from June to October 2024. Parents of hospitalized children with cancer were selected for …

Improving Patients' Experience Through Nurturing Care For Patients Undergoing Kidney Biopsies: A Feedback Survey, Molefe Rapalai, Mahmoud Elshehawy, Johann Nicholas, Patrick Anthony Ball, Hana Morrissey

Patient Experience Journal

Background: Renal biopsies are a key tool in diagnosing kidney diseases, providing histopathological insights for personalised treatment plans. Despite their clinical value, little is explored about how patients experience this invasive procedure. Understanding these experiences is important for improving care quality, safety, and ensuring the process is as patient friendly as possible. There is also a lack of research capturing patient experience feedback on renal biopsies, making studies like this essential for guiding service improvement initiatives. Method: Observational study, May 2022 to June 2024. Eighty-six percutaneous renal biopsies performed. Fifty eligible patients invited to complete the Kidney Biopsy Patient Experience …

Capturing Patient-Centered Quality Of Life: Usability And Initial Validation Of The Pediatric Patient-Generated Index Following Esophageal Atresia Repair, Zanib Nafees, Julia Ferreira, Elena Guadagno, Nikki Ow, Nancy Mayo, Jean-Martin Laberge, Dan Poenaru

Patient Experience Journal

The Patient-Generated Index (PGI) is an individualized measure that allows patients to define the domains most important to their quality of life (QoL). This study evaluates the usability and preliminary validity of the pediatric Patient-Generated Index (pPGI) in children who previously underwent esophageal atresia (EA) repair. We conducted a mixed-methods study including the pPGI, EuroQol-5D-Youth (EQ-5D-Y), and PROMIS Life Satisfaction Short Form-8a. Children aged 7–17 years completed self-reports, while parents served as proxies for younger children. Cognitive interviews explored how children understood and completed the pPGI, and clinician interviews assessed clinical usability. Among 25 participants, the pPGI generated 104 text …

Family Perspectives: A Qualitative Examination Of College Athlete Suicide During The Spring 2022 Semester, Elaine M. Anton-Lotruglio, Sophia M. Burke, Kimberly H. Mcmanama O'Brien

Journal of Issues in Intercollegiate Athletics

Objective: Suicide among college athletes remains largely underexplored despite rising rates. This qualitative study aimed to explore family members' perspectives on why their loved ones died by suicide. Participants: The study included family members (N=10) of three college athletes who died by suicide in the spring 2022 semester. Methods: Semi-structured interviews were conducted between March and July 2024. ATLAS.ti and Braun and Clarke's thematic analysis were employed to analyze the data and identify themes. Results: The data revealed three primary themes: factors contributing to the suicide crisis, presence of a suicide crisis, and university crisis response. The themes suggested a …

Beyond The Playing Field: Athletic Identity, Academic Performance, And Career Readiness Among Student-Athletes, Lucy Mcafee, Alexander Traugutt, Caroline J. Ketcham, Eric E. Hall

Journal of Issues in Intercollegiate Athletics

This mixed-methods study examined how athletic participation relates to perceived career readiness development and explored relationships between athletic identity, academic performance, and post-graduation plans among 124 Division I student-athletes (varsity and club) at a private university. Participants completed surveys measuring athletic identity (AIMS), perceived development of NACE Career Readiness competencies, and open-ended questions about how athletics prepared them for future careers. Varsity athletes reported significantly higher perceived development than club athletes across five competencies: professionalism, critical thinking, communication, technology, and career and self-development. Male athletes reported higher perceived development in professionalism, critical thinking, and technology. Athletic identity demonstrated significant positive …

The Make And Model Of A Hero: Training And Transformation In Sundiata:An Epic Of Old Mali, Anna Stowe

Butler Journal of Undergraduate Research

This paper examines Sundiata: An Epic of Old Mali through the lens of the hero’s journey, tracing the boyhood, exile, and transformation of Sundiata as he prepares to restore Mali to peace and prosperity. Leadership is both an individual calling and a communal responsibility; true rulers depend not only on personal strength but also on the support and guidance of others. While in exile, Sundiata receives military, political, and supernatural training, all of which shape his identity as the epic’s hero and equip him to achieve his destiny. These trials mirror the stages of growth and preparation found in scripture. …